Related Experiment Video
Updated: Feb 10, 2026
Dynamic Adhesion Assay for the Functional Analysis of Anti-adhesion Therapies in Inflammatory Bowel Disease
Published on: September 20, 2018
Differentiation Between Pediatric Irritable Bowel Syndrome and Inflammatory Bowel Disease Based on Fecal Scent: Proof
Sofie Bosch1, Nora van Gaal1, Roy P Zuurbier2
1Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, the Netherlands.
Insights
Fecal volatile organic compounds (VOCs) can accurately distinguish pediatric inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS) and functional abdominal pain. However, VOC analysis cannot differentiate IBS/FAP from healthy controls, limiting its use as a standalone biomarker for these conditions.
Area of Science:
- Gastroenterology
- Biomarker Discovery
- Microbiome Research
Background:
- Pediatric irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) diagnosis often requires invasive tests to rule out inflammatory bowel disease (IBD).
- There is a need for noninvasive diagnostic biomarkers for pediatric IBS/FAP-NOS.
- Fecal volatile organic compounds (VOCs) are potential biomarkers reflecting gut microbiota alterations.
Purpose of the Study:
- To evaluate the utility of fecal VOC analysis in differentiating pediatric IBS/FAP-NOS from IBD and healthy controls (HCs).
Main Methods:
- Fecal VOCs were analyzed using field asymmetric ion mobility spectrometry (FAIMS).
- Participants included 15 pediatric IBS/FAP-NOS patients, 30 IBD patients (ulcerative colitis and Crohn's disease), and 30 HCs, aged 4-17 years.
- Diagnosis was based on ROME IV criteria for IBS/FAP-NOS.
Main Results:
- Fecal VOC analysis achieved high accuracy in differentiating IBS/FAP-NOS from IBD (AUC, 0.94).
- Differentiation between IBD and HCs was also highly accurate (AUC, 0.96).
- However, fecal VOC profiles did not significantly differentiate IBS/FAP-NOS from HCs (AUC, 0.59).
Conclusions:
- Fecal VOC analysis can accurately distinguish pediatric IBS/FAP-NOS from IBD.
- Fecal VOCs show potential as an additional noninvasive biomarker to differentiate IBS/FAP-NOS from IBD.
- The inability to differentiate IBS/FAP-NOS from HCs limits the use of fecal VOCs as a standalone diagnostic biomarker for IBS/FAP-NOS.
Background:
The diagnostic work-up of pediatric irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) commonly includes invasive tests for discrimination from inflammatory bowel disease (IBD). As this carries a high burden on patients, an ongoing need exists for development of noninvasive diagnostic biomarkers for IBS and FAP-NOS. Several studies have shown microbiota alterations in IBS/FAP, which are considered to be reflected by fecal volatile organic compounds (VOCs). The object of the study was to evaluate whether pediatric IBS/FAP-NOS could be discriminated from IBD and healthy controls by fecal VOC analysis.
Methods:
IBS/FAP-NOS was diagnosed according to the ROME IV criteria, and de novo IBD patients and healthy controls (HCs) aged 4 to 17 years were matched on age and sex. Fecal VOCs were analyzed by means of field asymmetric ion mobility spectrometry.
Results:
Fecal VOCs of 15 IBS/FAP-NOS, 30 IBD (15 ulcerative colitis, 15 Crohn's disease) patients and 30 HCs were analyzed and compared. Differentiation between IBS/FAP-NOS and IBD was feasible with high accuracy (area under the curve [AUC], 0.94; 95% confidence interval [CI], 0.88-1; P < 0.00001). IBS/FAP-NOS profiles could not be differentiated from HCs (AUC, 0.59; 95% CI, 0.41-0.77; P = 0.167), whereas IBD profiles could with high accuracy (AUC, 0.96; 95% CI, 0.93-1; P < 0.00001).
Conclusion:
Pediatric IBS/FAP-NOS could be differentiated from IBD by fecal VOC analysis with high accuracy, but not from healthy controls. The latter finding limits the potential of fecal VOCs to serve as a diagnostic biomarker for IBS/FAP-NOS. However, VOC could possibly serve as additional noninvasive biomarker to differentiate IBS/FAP-NOS from IBD. 10.1093/ibd/izy151_video1izy151.video15786446046001.
Related Concept Videos
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:30Irritable Bowel Syndrome III: Medical and Nursing Management